Improve Resilience in First-Responders with a Smartphone Mindfulness App
By John M. de Castro, Ph.D.
“The mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony
First responders such as firefighters and police experience a great deal of stress and frequent traumatic events and as a part of their jobs. The first-responders need to be resilient in the face of these difficult circumstances to cope with the stress. It is possible that mindfulness training might help. Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help to develop resilience in first-responders and be of benefit to their mental health.
In today’s Research News article “Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/), Joyce and colleagues examine the ability of mindfulness training delivered with a smartphone app to increase the levels of resilience in first-responders. They recruited Primary Rescue and Hazmat firefighters and randomly assigned their stations to either receive 6, 20-25 minute, sessions of mindfulness training or to an Healthy Living control condition. The mindfulness training was based upon Acceptance and Compassion Therapy (ACT) and emphasized mindfulness, self-acceptance, and compassion. Both programs were delivered through a smartphone app. The first-responders were measured before and after training and 6 months later for mindfulness, resilience, cognitive fusion, experiential avoidance and psychological inflexibility, self-compassion, optimism, coping orientation, and life purpose.
They found that in comparison to baseline and the control condition, participation in the mindfulness training resulted in a significant increase in adaptive resilience and mindfulness which continued to increase over the 6-month follow-up period. Significant differences in optimism, and the use of instrumental and emotional support were present at the end of training but were not sustained at follow-up. Interestingly, there were no significant differences in “bounce-back” resilience.
Adaptive resilience involves the ability to adapt to stressful life circumstances and events. It involves the “individual’s ability to tolerate experiences such as change, personal problems, illness, pressure, failure, and painful feelings.” On the other hand, “bounce-back” resilience involves the ability to recover from stressful events. Since mindfulness focuses the individual on the present moment, it would be expected that it would influence the experience and coping with stressful events as they’re occurring. This is the case with adaptive resilience. On the other hand, mindfulness moves attention away from past events and would thus not be expected to influence coping with past stressful events as is the case with “bounce-back” resilience. Hence, it makes sense that mindfulness training would affect adaptive resilience and not “bounce-back” resilience.
It is important for the well-being of first responders that they be able to cope with the, at times, intense stress and trauma involved in their jobs. Hence, mindfulness training may be very beneficial as the present results suggest. This may help to prevent illness, burnout, and post-traumatic stress disorder (PTSD). In addition, the fact that mindfulness was taught with a smartphone app is important as it makes the training convenient and adaptable to the individual’s schedule. It is also highly scalable allowing for inexpensive widespread availability of the training.
So, Improve Resilience in First-Responders with a Smartphone Mindfulness App.
“Because PTSD is an anxiety disorder, episodes of distress occur when a person begins to worry about the future based on previous painful, intense or stressful memories. Meditation can help bring that person’s attention back to the current moment, which reduces or eliminates anxiety.” – Erin Fletcher
CMCS – Center for Mindfulness and Contemplative Studies
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Joyce, S., Shand, F., Lal, T. J., Mott, B., Bryant, R. A., & Harvey, S. B. (2019). Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. Journal of medical Internet research, 21(2), e12894. doi:10.2196/12894
A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.
This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.
We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.
Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).
The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.